Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients

Introduction: Breast cancer is the most common malignancy in women, and it is the second leading cause of malignancy-related mortality in women after lung cancer. Locally advanced breast cancer is a clinically heterogeneous group with a broad spectrum. Neoadjuvant chemotherapy (NAC) is the standard...

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Main Authors: Çiğdem Yıldırım, Fatih Teker, İlker Nihat Ökten, İlkay Gültürk, Aydın Aytekin, Alper Aytekin, Latif Yılmaz, Çiğdem Usul Afşar
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Language:English
Published: Galenos Yayinevi 2024-11-01
Series:İstanbul Medical Journal
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Online Access:https://istanbulmedicaljournal.org/articles/relationship-of-neoadjuvant-chemotherapy-efficacy-with-histopathologic-molecular-subtypes-in-breast-cancer-patients/doi/imj.galenos.2024.96266
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author Çiğdem Yıldırım
Fatih Teker
İlker Nihat Ökten
İlkay Gültürk
Aydın Aytekin
Alper Aytekin
Latif Yılmaz
Çiğdem Usul Afşar
author_facet Çiğdem Yıldırım
Fatih Teker
İlker Nihat Ökten
İlkay Gültürk
Aydın Aytekin
Alper Aytekin
Latif Yılmaz
Çiğdem Usul Afşar
author_sort Çiğdem Yıldırım
collection DOAJ
description Introduction: Breast cancer is the most common malignancy in women, and it is the second leading cause of malignancy-related mortality in women after lung cancer. Locally advanced breast cancer is a clinically heterogeneous group with a broad spectrum. Neoadjuvant chemotherapy (NAC) is the standard treatment at this stage. The present study aimed to evaluate the efficacy of NAC in terms of histopathologic molecular subtypes. Methods: The study included 183 patients receiving NAC. Patients were studied in three groups: Luminal tumors, human epidermal growth factor receptor-2 (HER-2)-positive tumors, and triple-negative tumors based on the expressed receptor status. In our retrospective review, we only examined pathological complete response (pCR) based on breast tumor shrinkage before and after chemotherapy. In this study, we evaluated factors affecting pathologic complete response in patients receiving NAC. Results: According to breast cancer subtypes based on biopsy results, pCR developed in 8 of 20 patients with triple-negative tumors (40%), 24 of 61 patients with HER-2-positive tumors (39.3%), and 22 of 102 patients with luminal tumors (21.5%) (p=0.030). The pCR rate was available in 5 of 40 patients with lymphovascular invasion (LVI) (12.5%) and 49 of 143 patients without LVI (34.2%) (p=0.008). pCR was available in 1 of 16 patients with perineural invasion (PNI) (6.6%) and 53 of 168 patients without PNI (31.5%) (p=0.043). PCR was available in 2 of 25 patients with extracapsular lymph node invasion (8%) and in 52 of 158 patients without extracapsular lymph node invasion (32.9%) (p=0.011). Conclusion: The NAC pCR rate of hormone-positive tumors was lower than that of hormone-negative tumors in breast cancer. This finding was related to the biological response of the tumor in heterogeneous breast cancer.
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publishDate 2024-11-01
publisher Galenos Yayinevi
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series İstanbul Medical Journal
spelling doaj-art-e32a2ade1a874c5a91a60a3e9550ebf92024-11-29T08:04:31ZengGalenos Yayineviİstanbul Medical Journal2619-97932148-094X2024-11-0125427428010.4274/imj.galenos.2024.96266Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer PatientsÇiğdem Yıldırım0https://orcid.org/0000-0002-9439-5941Fatih Teker1https://orcid.org/0000-0003-4693-6587İlker Nihat Ökten2https://orcid.org/0000-0003-2360-3392İlkay Gültürk3https://orcid.org/0000-0003-1998-3150Aydın Aytekin4https://orcid.org/0000-0002-7001-3945Alper Aytekin5https://orcid.org/0000-0003-2872-5276Latif Yılmaz6https://orcid.org/0000-0003-2528-9691Çiğdem Usul Afşar7https://orcid.org/0000-0002-3764-7639University of Health Sciences Turkey, İstanbul Training and Research Hospital, Clinic of Medical Oncology, İstanbul, TurkeyLiv Hospital, Clinic of Medical Oncology, Gaziantep, Turkeyİstanbul Oncology Hospital, Clinic of Medical Oncology, İstanbul, TurkeyUniversity of Health Sciences Turkey, İstanbul Training and Research Hospital, Clinic of Medical Oncology, İstanbul, TurkeyGaziantep University, Şahinbey Training and Research Hospital, Clinic of Medical Oncology, Gaziantep, TurkeyGaziantep University, Şahinbey Training and Research Hospital, Clinic of General Surgery, Gaziantep, TurkeyGaziantep University, Şahinbey Training and Research Hospital, Clinic of General Surgery, Gaziantep, TurkeyUniversity of Health Sciences Turkey, İstanbul Training and Research Hospital, Clinic of Medical Oncology, İstanbul, TurkeyIntroduction: Breast cancer is the most common malignancy in women, and it is the second leading cause of malignancy-related mortality in women after lung cancer. Locally advanced breast cancer is a clinically heterogeneous group with a broad spectrum. Neoadjuvant chemotherapy (NAC) is the standard treatment at this stage. The present study aimed to evaluate the efficacy of NAC in terms of histopathologic molecular subtypes. Methods: The study included 183 patients receiving NAC. Patients were studied in three groups: Luminal tumors, human epidermal growth factor receptor-2 (HER-2)-positive tumors, and triple-negative tumors based on the expressed receptor status. In our retrospective review, we only examined pathological complete response (pCR) based on breast tumor shrinkage before and after chemotherapy. In this study, we evaluated factors affecting pathologic complete response in patients receiving NAC. Results: According to breast cancer subtypes based on biopsy results, pCR developed in 8 of 20 patients with triple-negative tumors (40%), 24 of 61 patients with HER-2-positive tumors (39.3%), and 22 of 102 patients with luminal tumors (21.5%) (p=0.030). The pCR rate was available in 5 of 40 patients with lymphovascular invasion (LVI) (12.5%) and 49 of 143 patients without LVI (34.2%) (p=0.008). pCR was available in 1 of 16 patients with perineural invasion (PNI) (6.6%) and 53 of 168 patients without PNI (31.5%) (p=0.043). PCR was available in 2 of 25 patients with extracapsular lymph node invasion (8%) and in 52 of 158 patients without extracapsular lymph node invasion (32.9%) (p=0.011). Conclusion: The NAC pCR rate of hormone-positive tumors was lower than that of hormone-negative tumors in breast cancer. This finding was related to the biological response of the tumor in heterogeneous breast cancer.https://istanbulmedicaljournal.org/articles/relationship-of-neoadjuvant-chemotherapy-efficacy-with-histopathologic-molecular-subtypes-in-breast-cancer-patients/doi/imj.galenos.2024.96266breast cancerneoadjuvant chemotherapymolecular subtypepathological response
spellingShingle Çiğdem Yıldırım
Fatih Teker
İlker Nihat Ökten
İlkay Gültürk
Aydın Aytekin
Alper Aytekin
Latif Yılmaz
Çiğdem Usul Afşar
Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients
İstanbul Medical Journal
breast cancer
neoadjuvant chemotherapy
molecular subtype
pathological response
title Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients
title_full Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients
title_fullStr Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients
title_full_unstemmed Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients
title_short Relationship of Neoadjuvant Chemotherapy Efficacy with Histopathologic Molecular Subtypes in Breast Cancer Patients
title_sort relationship of neoadjuvant chemotherapy efficacy with histopathologic molecular subtypes in breast cancer patients
topic breast cancer
neoadjuvant chemotherapy
molecular subtype
pathological response
url https://istanbulmedicaljournal.org/articles/relationship-of-neoadjuvant-chemotherapy-efficacy-with-histopathologic-molecular-subtypes-in-breast-cancer-patients/doi/imj.galenos.2024.96266
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